Nothing hurts like knowing our loved ones are not doing well, but always keep in mind that there are clear ways to support them. Whether they're in treatment already or you're looking for ways to help them towards care, here's how to help a depressed spouse.
Recognizing a Depressed Spouse: Symptoms of Depression
Depression is understandably associated with sadness or dysphoria, but the emotions connected to the condition are much more complicated. Symptoms of depression outlined in the DSM-5 need to last for at least two weeks, and include persistent or recurrent:
- Emptiness or apathy
- Frustration or irritable feelings
- Guilt, blame, and weakness
At the same time, depression affects the way our bodies and brains work, our behavior, and our thought processes. Someone struggling with depression may:
- Experience trouble concentrating, remembering, or appearing indecisive
- Show a loss of interest or enjoyment from hobbies or activities they normally take pleasure in
- Feel physical pains, aches, cramps, or gastrointestinal trouble without any clear physical mechanism
- Struggle with arousal, and/or experience libido changes
- Have difficulty sleeping, staying asleep, or, oversleeping
- Over- or under-eat, often resulting in rapid weight changes
- Experience thoughts of suicide
These are symptoms, but not a checklist. If only some of these ring true to your spouse's feelings or behavior, while there's no sign of others, unfortunately, that does not necessarily mean that your partner is any less depressed. Any symptoms on this list are cause for concern, and if your spouse is not currently seeking help but you've witnessed a change in their mood or behavior that's lasted for weeks or a few months, it may be time to open a dialogue about what is going on.
Unpacking Myths about Depression
Depression is one of the most common illnesses in the country, and, around the world, but that doesn't stop us from holding a lot of misconceptions about it that can do more harm than good when you're navigating it with a partner. It can be a little hard to accept that we may hold onto false beliefs or stigmas about our loved ones, but in the interest of meaningful communication, it can be valuable to sit with some of the more common myths before jumping straight into support.
Mental Illness Isn't "Medical"
It may seem trite to reiterate this, but in the US depression is a condition loaded with connotations and conflicting messaging, and ironically, our closest loved one can be the one that triggers the stigmatizing thoughts and beliefs that we are inundated with throughout our lives.
Depression is a medical condition, and a complex one with many combinations of psychological, biological, and social origins. Many forms of well-researched and practiced medical and therapeutic interventions exist for it, and these can make an enormous difference in reclaiming health and happiness.
Depression Without Suicidal Thoughts Is Not Serious
Suicidal thoughts incorporate generalized thoughts of "not living," contemplations about the process or consequences of an attempt on one's own life, or clearer thought-through plans to do so, which can all be extremely harrowing aspects of someone's experience of depression. However, if your depressed husband or wife does not have these, or does not vocalize them, it is not a sign that they are struggling less.
Men Don't Experience Depression
Associations that exist connecting depression to the female experience don't do either gender any favors in getting the support they need. Research suggests that on average, men may experience or express depression differently, specifically having a harder time communicating about feelings of emotional pain or helplessness when they feel them. Narratives like these are dangerous, resulting in a lot of self-blame and silence, and contribute to the greater risk of suicide in men.
Antidepressants Will Always Fix It
Depression has physiological elements in the brain that can be treated in some cases with prescribed medication. This works for some people, but for most people, medication is not enough to resolve depression on its own. Talk therapy, counseling, as well as guided changes to our lifestyles and behaviors are a part of many people's ultimate recovery from this condition.
Depression Needs to Be Connected to an Event
Periods of clinical depression can come on due to an event such as a death of a loved one, an end to a cherished relationship, an illness, or another crisis - but depression does not have to have an incidental cause.
A Thriving Relationship Can "Cure" A Depressed Husband
This can be hard to accept when you are concerned about the person you are building your life with, but the mental health of each respective partner is not a litmus test for the quality of the marriage or relationship. These things can be connected, but more often than not, they aren't - and extrapolating too much can be painful and unhelpful. Enlisting the help of a therapist or counselor is a very good idea when it comes to parsing what is personal and what is not.
Reaching Out to a Loved One or a Mental Health Professional
Speaking about a concern like depression can be a taxing, anxious idea even for people who know each other best. These conversations are emotional, sensitive, and can easily veer off in angry or desolate directions.
If you are approaching your depressed partner for the first time about your concerns, make sure you are doing it at a time when you are both at your most secure, open, and communicative. Before having the conversation, you may want to take some time to think and understand your feelings and develop a focused picture of your goals for the conversation.
Center your feelings of care, and keep in mind, your best course of action in the long term will be supporting your spouse in accessing treatment. Every person and every relationship operates differently, but be prepared for some denial or resistance. If you suspect that either of your feelings of hurt will be hard to manage, reach out to a mental health professional.
If you and your spouse are aware of the condition, but you just want to have a clearer picture of how to help, you're doing the right thing by reaching out to them. It's a good idea to ask them how they're doing first, to let them know that you have been thinking about their condition, and eventually that you are looking for ways to support them in their journey to cope and recover.
More often than not, people who are dealing with depression simply want to be heard. Asking how they are, and asking if there's anything you can do, is nearly universally the right approach.
The other pillar of support for a depressed spouse is to encourage them to accept and commit to treatment. If you haven't had this conversation with them yet, you may want to put in some legwork by looking into the treatments that are available to help your partner cope with or cure their depression.
When it's time to talk, you don't need to apply pressure for this to be heard by your spouse. Forcing depressed men into therapy or walking them down to the family doctor for medication is not a very effective approach to long-term mental health changes. Use a soft touch, and if they aren't ready to accept treatment or are still uncomfortable speaking to you about it, encouraging them to speak to a close friend or family member can be a helpful start.
Efforts to listen with judgment, ask questions in ways that don't lead, and promote treatment are the key tools you can employ to help the two of your get your lives back. Beyond that, there are many small changes to lifestyle, mindset, and behavior that you can take on in your work to encourage recovery.
Depression is a lonely state, and if you have a depressed spouse you probably do not need to be told that it leads people to withdraw, in both subtle and overt ways, from the people closest to them. At the same time, isolation breeds depression, and so people struggling with loneliness can rapidly trap themselves in a vicious cycle.
As this person's partner, you are uniquely positioned to combat this without being pushy or overbearing. Reach out to the friends they care most about with inclusive plans, and try to make sure the two of you aren't spending all of your time at work or home. If you have children or a supportive family nearby, gentle nudges that your spouse could use a bit more quality time can be powerful and don't require you to air their full emotional state.
When you check in with any depressed person in your life, exercise active listening. The purpose of reaching out in this way isn't always to find ways to respond or solve things but to give them space to talk and feel supported in their emotions without any blame or shame. Give them your focus, and listen to listen, not react. They may need to vent, they may need to cry - you won't know unless you're making an effort to be fully present.
On the subject of needs, not everyone will want to talk about how they're feeling 100% of the time. If your spouse has verbalized or indicated that they need space, quiet, or distraction that is in some way separate from yourself, give them that. If you need to talk for your reasons, ask them if you can speak sometime soon, and as always, let them know you're there when they need you.
Organize Your Environment
Simple tasks like washing up and organizing schedules can be overwhelmingly difficult in the midst of a depressed episode, while at the same time chaos and mess around the house can compound and make us feel a lot worse. Where it's possible, it can be helpful for your partner if you take a little extra care to keep the fundamentals of your material lives in order while they're in the process of recentering themselves
People with mood disorders of all kinds are more likely to abuse alcohol or self-medicate with drugs and other substances when they're feeling especially low. While this may give some semblance of control, it is a deeply dangerous coping strategy and one of the leading causes of eventual substance use disorders - not to mention the fact that hangovers and come downs do not support mental health in any way. If you drink together a lot as a couple, it's a good idea to dial it back, at a minimum until everyone is feeling grounded - for everyone's sake.
Much like household chores and social engagements, the behaviors that keep us healthy often get sidelined in depression. Getting enough sleep, eating well, and exercise have all been closely connected to improved mental health and resilience. Encouraging your spouse to take a walk together, cook meals or eat out together, and maintain regular sleep schedules are some of the simplest, most enjoyable moves you can make to help one another.
Looking After Yourself
Depression affecting your marriage is not easy - and both you and your partner can stand a lot to benefit from support groups, counseling, and therapy. Make sure that you are following the above pieces of advice for yourself as well, and accept that dealing with your feelings may take considerable work. Rely on family members, friends, and professional help whenever needed, and don't forget to give yourself as much care as you do your spouse.
At Cornerstone, we understand the suffering that depression, trauma, and anxiety can cause for both individuals and couples. We have years of experience providing compassionate, professional mental health treatment and therapy to our clients, with a focus on helping everyone achieve the happy ending we all hope for. If a spouse or other loved one is struggling with depression, contact us today for a chat and advice about treatment options.